Provider Demographics
NPI:1780816611
Name:RICHARD, TIMIKI A (RN, FNP-C)
Entity Type:Individual
Prefix:
First Name:TIMIKI
Middle Name:A
Last Name:RICHARD
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8608 N HIGHWAY 146 STE 600
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77523-7506
Mailing Address - Country:US
Mailing Address - Phone:832-556-6936
Mailing Address - Fax:281-428-7035
Practice Address - Street 1:8608 N HIGHWAY 146 STE 600
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77523-7506
Practice Address - Country:US
Practice Address - Phone:832-556-6936
Practice Address - Fax:281-428-7035
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX773049363LF0000X, 363LF0000X
LA05875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR179167758Medicaid